This is Part 2 of a two-part interview. Read Part 1 here.

In part two of my interview with Daniela Schiller, Professor of Neuroscience and Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai and Director of the Schiller Laboratory of Affective Neuroscience, we discuss how current neuroscience research is confirming many of the working hypotheses of psychotherapy and the role of narrative in creating memories.

Dale Kushner: There has been a lot of research about how our brains are wired for narrative.1 Your research,2 which we began discussing in Part 1, has to do with contextualizing a memory, that when a memory is contextualized that somehow mitigates the traumatic effects. How would you explain that?

Daniela Schiller: Yes. I think it’s important to emphasize that many of the insights I'm talking about are widely known and used in psychotherapy and psychological research. We've known for many decades that memories are not accurate, that there can be false memories, that they can be affected. And also that you need to create a narrative. Many therapy forms are about creating a narrative around memories because traumatic memories are fragmented.

In a way, neuroscience research is catching up or even occurring in parallel. When you interpret the neurobiological or neuroscientific findings, you see that, oh, it comes to the same conclusion as the therapists. Neuroscience brings a mechanism, whereas, for psychologists and psychiatrists, the therapy has been developed through trial and error or through hypothesis. It brings structure and constraints. But if there's a mechanism, together they can kind of constrain each other. Now there's a mechanism, now we know exactly what to target in a more well-defined treatment. The neuroscience resonates with many observations in psychology. It's exciting.

DK: Now that you and your team and other researchers understand these mechanisms, what impact will this have on pharmaceuticals? Or in treatment? We hear of people recreating their nightmares in imagery rehearsal therapy.3 How could this be used?

DS: Let me answer in two steps. In terms of narrative, memories are part of a narrative almost by definition. A memory is something that is embedded in time and space in a certain context, at least episodic memory. And if it's not, then it's a fragment of a present moment. To make something into a memory, it has to be part of a narrative because memory is a narrative. The brain is very much prone to that. The reason is that narrative is something that gives you cause and effect. It allows you to understand and predict, which is precisely what the brain wants to do.

So the connection with narrative is very tight. At the same time, there's room for flexibility in that narrative because we know that memories are not accurate. We keep changing them, we reconstruct them. So when we do hold onto a narrative, it's like a hypothesis. It's a plausible explanation of the event. And that is what is liberating because if you're stuck in a very harmful, negative narrative, there's room to think that maybe it's not the reality. There's room to modify it and turn it into something more accurate and more conducive.

In terms of pharmaceuticals, it's an interesting interplay because it depends on the impairment. In some cases, it could be at the neurobiological level, so you need something to, let's say, enhance the brain's plasticity or help neurons recover or return to balanced action. For this, you would need some type of invasive, like a drug or brain stimulation.

But at the same time, once the brain is functioning, you need to overlay behavior on it. It's like having a car that works, but not driving it or driving a car that doesn't work. If the car works and you don't learn how to drive, there's no point, right? It doesn't really help you that the car works. So, if you can stimulate the brain to put it on a functional level, you then must practice behavior. The combination is very important. For different people, it depends on the situation. Sometimes the neurological is fine and you just need to practice behavior. Behavior itself is like a drug in the sense that it shapes the memory. It can stimulate, can train the memory. Behavior is a product of the brain, but it’s also a trainer, a manipulator of the brain. Behavior is very powerful. There is a lot of room for pure behavioral interference or adjustments that people can make in their daily lives when they understand how the brain works.

DK: That's fantastically hopeful. What else should we know about what you have learned in your research?

DS: All these insights that come from neuroscience and psychology about memory are changing the way we think about memory. This is potentially important for how people engage with their memories. Because in everyday life we assume that our memories are accurate and they define who we are. This is what meditation is giving you. It's a way to observe and interact with your thoughts and with your memories such that they don't define you. You have a relationship with them, and that gives you a great deal of flexibility. On the one hand, it can be disturbing to think that I am not being correct in what I think about myself. But it changes your perspective in the sense that you don't need to look in the past to understand who you are.

You need to look at the present because whatever you retrieve now reflects who you are now. For example, if you're in a negative mood, you will retrieve negative memories. This is what will come to mind. It doesn't mean that this is your entire life. It just means that now this is what you're experiencing. So, you kind of think about memories differently. It's not about telling you who you are or not, they give you actual information about the present in a way that helps you predict the future. Each one of us is becoming like an artist in the sense that we feel the memories and interact with them and have more of an intuitive sense of the process. I think it frees us, it gives us much more flexibility in moving forward in our experience of ourselves.

DK: Great. And that aligns with a sort of spiritual perspective. That our capacity, our perceptions, are narrowed by memory and many other things. But our capacity is so much more expansive.

DS: I think the affective world, the world of affect, which is everything from emotion, feelings, and mood, is best understood from the perspective of being an organism. You’re an organism in the world. You interact with the world and your reactions to the world. What we call emotions are concerns that we have for our survival. If we interact with something in the environment, that's important to our survival or the way we interact with it. It indicates the importance or the relevancy of that object. That could be a mental object or a physical object, but the way we interact with it signifies what it means for us in terms of our survival.

References

1. Westover, Jonathan, "The Power of Storytelling: How Our Brains are Wired for Narratives," Human Capital Innovations, January 11, 2024

2. O. Perl, O. Duek, K. Kulkarni, C. Gordon, J. H. Krystal, I. Levy, I. Harpax-Rotem, D. Schiller, “Neural patterns differentiate traumatic from sad autobiographical memories in PTSD,Nature Neuroscience, 26, 2226-2236 (2023); Published November 30, 2023.

3. M. Albanese, M. Liotti, L. Cornacchia, F. Manzini, "Nightmare Rescripting: Using Imagery Techniques to Treat Sleep Disturbances in Post-traumatic Stress Disorder," Frontiers in Psychiatry, 2022: 13: 866144

QOSHE - Memory and Trauma: We Are More than What We Remember - Dale M. Kushner
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Memory and Trauma: We Are More than What We Remember

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23.01.2024

This is Part 2 of a two-part interview. Read Part 1 here.

In part two of my interview with Daniela Schiller, Professor of Neuroscience and Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai and Director of the Schiller Laboratory of Affective Neuroscience, we discuss how current neuroscience research is confirming many of the working hypotheses of psychotherapy and the role of narrative in creating memories.

Dale Kushner: There has been a lot of research about how our brains are wired for narrative.1 Your research,2 which we began discussing in Part 1, has to do with contextualizing a memory, that when a memory is contextualized that somehow mitigates the traumatic effects. How would you explain that?

Daniela Schiller: Yes. I think it’s important to emphasize that many of the insights I'm talking about are widely known and used in psychotherapy and psychological research. We've known for many decades that memories are not accurate, that there can be false memories, that they can be affected. And also that you need to create a narrative. Many therapy forms are about creating a narrative around memories because traumatic memories are fragmented.

In a way, neuroscience research is catching up or even occurring in parallel. When you interpret the neurobiological or neuroscientific findings, you see that, oh, it comes to the same conclusion as the therapists. Neuroscience brings a mechanism, whereas, for psychologists and psychiatrists, the therapy has been developed through trial and error or through hypothesis. It brings structure and constraints. But if there's a mechanism, together they can kind of constrain each other. Now there's a mechanism, now we know exactly what to target in a more well-defined treatment. The neuroscience resonates with many observations in psychology. It's........

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